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Anteayer Journal of Advanced Nursing

The Symptoms and Impacts Experienced by Healthcare Professionals as Second Victims After a Safety Incident: A Scoping Review

ABSTRACT

Aim

This study aimed to describe the types of psychological and physical symptoms experienced by healthcare professionals who became second victims after a patient safety incident and the impact of the incident on their social and professional lives.

Design

Scoping review.

Methods

JBI methodology for scoping reviews and PRISMA-ScR for reporting were followed.

Data Sources

The search was conducted on June 13, 2024, using the CINAHL (EBSCO), Scopus, PubMed (Medline), Medic and PsycInfo (EBSCO) databases. A grey literature search was also conducted.

Results

A total of 96 papers were included. Healthcare professionals experienced psychological symptoms such as anger, sadness and guilt after a safety incident. Physical symptoms were reported, including symptoms related to sleep and gastrointestinal symptoms. At the professional and social levels, the incident affected their work, relationships and well-being. Positive impacts were also noted.

Conclusions

This study provides a comprehensive overview of healthcare professionals' experiences after safety incidents. In addition, this study also captured the positive impacts of safety incidents, such as learning from mistakes.

Implications for the Profession and/or Patient Care

By recognising the symptoms and impacts associated with the second victim syndrome, appropriate support can be provided for healthcare professionals.

Impact

The findings of this study can be used to identify the relevant harm to professionals after a safety incident, which could help to improve the well-being of these workers.

Patient or Public Contribution

No patient or public contribution.

Protocol Registration

Open Science Framework, https://archive.org/details/osf-registrations-5cdmu-v1

Nurse and Other Healthcare Managers' Experiences and Recommendations for Patient Incident Reporting Processes and Real‐Time Software Development: A Qualitative Study

ABSTRACT

Aims

To (1) analyse managers' experiences with handling patient safety incident reports in an incident reporting software, identifying key challenges; (2) analyse the incident report processes from the managers' perspective; (3) examine managers' perceptions of ways to support and improve health professionals' experiences of report-handling processes; and (4) investigate how, from their point of view, incident reporting software should be developed in the future.

Design

A descriptive qualitative study.

Methods

Interviews and focus group discussions on Microsoft Teams from 11/2024 to 3/2025, including 16 participants, analysis with deductive and inductive content analysis.

Results

Of 16 participants, 15 were managers and one was a patient safety expert. Most were nurse managers (n = 9). Four discussion themes were divided into 30 categories. Participants highlighted the need to improve the reporting software's terminology, classification and analysis tools. The use of artificial intelligence was desired but not currently integrated into the software. Participants were unsure of their skills to use all the software features. Clear and transparent handling processes, feedback, managers' behaviour and communication methods were seen as key to improving staff's experience with report processes. A real-time warning system was considered beneficial for various incident types. Specific questions must be answered before further developing such systems.

Conclusion

This study deepened the understanding of reporting software's challenges regarding its handling features. The handling processes of incident reports had multiple shortcomings, which may negatively affect health professionals' experiences in report handling. Real-time warning systems could assist healthcare managers in processing reports.

Implications for the Profession and/or Patient Care

Organisational-level guidance for incident report processing is needed. Improvements to report processing and reporting software can improve shared learning and understanding of the status of patient safety.

Patient or Public Contribution

No patient or public contribution.

Reporting Method

COnsolidated criteria for REporting Qualitative research Checklist.

When Words Fail: ICU Nurses' Experiences Caring for Patients With Limited English Proficiency in the United States

ABSTRACT

Aims

To explore the lived experiences of intensive care nurses caring for patients with limited English proficiency.

Design

A hermeneutic, interpretive phenomenological design was used.

Methods

Semi-structured interviews were conducted with intensive care nurses recruited through purposive sampling. Data collection included Qualtrics screening surveys and semi-structured Zoom interviews. The research team, comprising linguistically diverse faculty and undergraduate research assistants, employed reflexivity techniques to minimise bias and enhance interpretive rigour. Data were analysed via inductive analysis using the hermeneutic circle.

Results

Five main themes emerged organically from the data: Complications of Care Relating to Verbal Communication Challenges. Benefits and Barriers of Nursing Informatics in Linguistic Care. The Universal Language: Nursing Effort Builds Trust. The Ripple Effect: Chronological Considerations for Patient Care. Moving Forward: Where Do We Go From Here?

Based on these findings, a four-phase model was developed to guide individual and system-level interventions to reduce nurse moral distress and improve language equity in critical care.

Conclusion

Language barriers in the intensive care unit hinder communication, increase stress for patients and nurses, and impact care quality. While nurses' efforts to bridge these gaps are valued, systemic changes (such as expanded interpreter availability and improved cultural safety training) are necessary to support culturally, linguistically, and medically appropriate care.

Implications for the Profession and/or Patient Care

Findings highlight the need for increased institutional support, additional resources for night-shift staff, and the integration of cultural humility education into intensive care training. The Limited English Proficiency Moral Distress Action Cycle for Critical Care Nursing, developed from this study, offers a flexible framework to guide the implementation of these improvements and reduce nurse moral distress. Future research should explore interventions to promote cultural and linguistic competence in multilingual patient populations.

Impact

Q: What problem did the study address?

A: The nurse-identified clinical, ethical, and workflow risks created when interpreters or translation tools are inadequate for critical care.

Q: What were the main findings?

A: Language barriers jeopardise teaching, informed consent, and symptom reporting. Video and phone interpreters or translation apps are vital but are often scarce, unreliable, or impersonal, particularly during night shifts. Nurses bridge these gaps by building trust through empathy, non-verbal communication, and learning key phrases. Yet, effective care for patients with limited English proficiency requires extra time, increasing workloads and fuelling moral distress related to language-discordant care. Nurses consistently called for 24/7 interpreter coverage; more reliable devices and cultural humility training must be implemented system-wide.

Q: Where and on whom will the research have an impact?

A: Findings can guide nurses, managers, leaders, and administrators to improve both language concordant and discordant nursing care and train nurses in cultural and linguistic competencies for a multilingual patient population. Ultimately, these efforts have been shown to improve the quality, outcomes, and cost-effectiveness of patient care. The study also identifies moral-distress triggers and introduces the Limited English Proficiency Moral Distress Action Cycle (LEP-MDAC). This model is proposed for use in other high-acuity settings worldwide that seek to provide language-concordant or language-discordant care effectively.

Reporting Method

SRQR.

Patient or Public Contribution

None.

Pharmacological Haemodynamic Management in the Intensive Care Unit: The Evolution of the Nurse's Role Over 50 Years

ABSTRACT

Aim

To examine the evolution of intensive care nurses’ roles in pharmacological haemodynamic management from 1975 to 2025 and to explore projected responsibilities through 2075.

Design

A scholarly commentary.

Methods

A critical synthesis of literature, historical accounts and clinical guidelines spanning 1975–2025, focussing on nursing practice, technology, workforce dynamics and patient safety in critical care pharmacology.

Data Sources

CINAHL, PubMed, EBSCO, Embase, Cochrane, Google Scholar and major pharmacological guideline repositories were searched for sources between 1975 and 2025, including clinical trials, systematic reviews, position papers and qualitative studies.

Results

Nurses have progressed from unstandardised vasoactive medication titration to advanced, protocol-driven multimodal vasopressor strategies. Milestones include the early catecholamine era, nurse-led sepsis protocols and contemporary adoption of peripheral vasopressor practices supported by technology. Looking ahead, intensive care nurses will increasingly supervise technologically driven titration, manage multimodal regimens, address drug shortages and sustain resilience amid workforce pressures.

Conclusion

Over the past five decades, nurses have transformed vasopressor management and remain essential in bridging innovation with ethical, patient-centred care. The next 50 years will require advanced decision-making, technological fluency and improved support for the nursing workforce.

Implications for the Profession and/or Patient Care

Investment in simulation-based education, workforce supports and ethical frameworks is vital to prepare nurses for expanding responsibilities and ensure patient safety.

Impact

Problem addressed

Historical variability and future challenges in nursing roles for vasopressor management.

Main findings

Nurses have driven safety and innovation and will face increasing technological, ethical and workforce demands.

Impact

Relevant to critical care nurses, nurse educators, nurse leaders and policy-makers worldwide shaping the future of critical care practice.

Taking Back the Authentic Nurse

Journal of Advanced Nursing, Volume 81, Issue 10, Page 6074-6075, October 2025.
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